Bottom Line:
The maximum follow up was for 8 years.The TVT type of slings had higher complication rate like needle entering the bladder, retention of urine necessitating to cut the tape in the center and had a success rate of 94.5% compared to Monarc/Trivedi obturator tape (TrOT) type of sling with outside-in technique, which had a negligible complication (less than 1%), pain in groin or leg movement that reduced in 6 weeks and a success rate of 95%.Specially, the Indian design Trivedi's stress urinary incontinence tape (TSUIT) and TrOT with reusable needles, the cost was only 15-20% of the international brands.

Aims and objectives: To evaluate the outcome of suburethral and transobturator sling in treatment of female stress urinary incontinence in 209 cases from 2002 to 2010. The criteria evaluated were success, failure, complications, operating time, ease of the procedure, availability and cost effectivity of the sling.

Design and setting: A retrospective comparative study was carried out at a tertiary referral centre for female urinary incontinence.

Material and methods: A total of 209 patients (females from 27 to 79 years of age) with proven stress urinary incontinence were treated by suburethral transvaginal tape (TVT) type of slings in 101 cases and transobturator Monarc type of sling in 108 cases at the National Institute of Endoscopic Surgery and Urinary Incontinence Center, Mumbai, India, from March 2002 to June 2010. The maximum follow up was for 8 years.

Results: The TVT type of slings had higher complication rate like needle entering the bladder, retention of urine necessitating to cut the tape in the center and had a success rate of 94.5% compared to Monarc/Trivedi obturator tape (TrOT) type of sling with outside-in technique, which had a negligible complication (less than 1%), pain in groin or leg movement that reduced in 6 weeks and a success rate of 95%. Specially, the Indian design Trivedi's stress urinary incontinence tape (TSUIT) and TrOT with reusable needles, the cost was only 15-20% of the international brands.

Mentions:
In TrOT [Figure 4a–f] or Monarc [Figure 5a–d] sling, the vaginal dissection was the same, the needles on each side were introduced in the genitofemoral crease at the medial most point of obturator foramen usually 2 cm above the external urethral meatus, from a 4-mm incision. The needle was first inserted perpendicularly perforating the obturator membrane. Then the shaft of the needle was turned outward by 45° and the tip of the needle was brought by rotatary movement under the inferior pubic ramus, to come out below the dissected vagina palpated by the tip of the other index finger. Then, the thread of the TSUIT tape was inserted in the eye of needle and tied in TrOT or snapped in Monarc. Needle was pulled out in anticlockwise direction. As the tape came out from both sides, a long artery at 45° was kept above the tape to avoid tension on the urethra. The excess tape projecting out of obturator foramen was cut and the vagina closed. No cystoscopy or catheter was needed.

Mentions:
In TrOT [Figure 4a–f] or Monarc [Figure 5a–d] sling, the vaginal dissection was the same, the needles on each side were introduced in the genitofemoral crease at the medial most point of obturator foramen usually 2 cm above the external urethral meatus, from a 4-mm incision. The needle was first inserted perpendicularly perforating the obturator membrane. Then the shaft of the needle was turned outward by 45° and the tip of the needle was brought by rotatary movement under the inferior pubic ramus, to come out below the dissected vagina palpated by the tip of the other index finger. Then, the thread of the TSUIT tape was inserted in the eye of needle and tied in TrOT or snapped in Monarc. Needle was pulled out in anticlockwise direction. As the tape came out from both sides, a long artery at 45° was kept above the tape to avoid tension on the urethra. The excess tape projecting out of obturator foramen was cut and the vagina closed. No cystoscopy or catheter was needed.

Bottom Line:
The maximum follow up was for 8 years.The TVT type of slings had higher complication rate like needle entering the bladder, retention of urine necessitating to cut the tape in the center and had a success rate of 94.5% compared to Monarc/Trivedi obturator tape (TrOT) type of sling with outside-in technique, which had a negligible complication (less than 1%), pain in groin or leg movement that reduced in 6 weeks and a success rate of 95%.Specially, the Indian design Trivedi's stress urinary incontinence tape (TSUIT) and TrOT with reusable needles, the cost was only 15-20% of the international brands.

Aims and objectives: To evaluate the outcome of suburethral and transobturator sling in treatment of female stress urinary incontinence in 209 cases from 2002 to 2010. The criteria evaluated were success, failure, complications, operating time, ease of the procedure, availability and cost effectivity of the sling.

Design and setting: A retrospective comparative study was carried out at a tertiary referral centre for female urinary incontinence.

Material and methods: A total of 209 patients (females from 27 to 79 years of age) with proven stress urinary incontinence were treated by suburethral transvaginal tape (TVT) type of slings in 101 cases and transobturator Monarc type of sling in 108 cases at the National Institute of Endoscopic Surgery and Urinary Incontinence Center, Mumbai, India, from March 2002 to June 2010. The maximum follow up was for 8 years.

Results: The TVT type of slings had higher complication rate like needle entering the bladder, retention of urine necessitating to cut the tape in the center and had a success rate of 94.5% compared to Monarc/Trivedi obturator tape (TrOT) type of sling with outside-in technique, which had a negligible complication (less than 1%), pain in groin or leg movement that reduced in 6 weeks and a success rate of 95%. Specially, the Indian design Trivedi's stress urinary incontinence tape (TSUIT) and TrOT with reusable needles, the cost was only 15-20% of the international brands.